One of the more disturbing things to come to light since the Dec. 16 Delhi gang rape is just how many cases of sexual violence in India involve children. In the media’s ongoing effort to keep attention on the problem of sexual assault, the fact that children are so frequently the victims of brutal sexual attacks has provided yet another rude wake up call, and a grim reminder that the cases coming to light are only a small part of a much bigger problem. (Have a look at the rolling headlines at the bottom of this page of the Times of India.) “There is a lot of attention on sexual violence now,” said Meenakshi Ganguly, South Asia director for Human Rights Watch, on Thursday. “We need to focus the attention on the sexual abuse of children.”

That is the goal of a new report by Human Rights Watch (HRW). The Feb. 7 report calls for the government to do more to protect children from sexual abuse. In more than 100 interviews, case studies of multiple child victims lay bare the pervasive institutional weaknesses and attitudes that have created a “conspiracy of silence” around child sex abuse in India. According to UNICEF, one in three rape victims in India is a child, and more than 7200 children are raped each year, with many more cases believed to go unreported. In 2007, a government-sponsored survey of 12,500 children in 13 states “reported serious and widespread sexual abuse,” but found that only 3% of the cases in which children said they had been abused had been reported to the police.

That serious under-reporting is due in large part to how victims are treated once they do make the difficult choice to come forward. In four of the cases documented in the report, victims said doctors had used the much-maligned “finger test” to determine whether they had been raped or not. This type of examination is permitted under current Indian law but is of little forensic value and risks re-traumatizing the victim. Doctors routinely showed outright insensitivity to the young victims, a fact that regularly discouraged families from pursuing their cases legally, the report found.

Reported cases can be met with callousness by the cops. Indian law mandates that every police station have a trained child welfare officer, and that every district have units to deal with juvenile cases. But the efficacy of the units varies wildly, particularly in under-resourced districts. In one case detailed in the HRW report, a 12-year-old girl named Krishna was raped by a man from a neighboring village in eastern Uttar Pradesh. When she went to report the crime, she says she was detained by police for nearly two weeks. “I was kept in the police station and locked up,” she told the rights group. “They kept insisting that I change my statement, otherwise they threatened that something would happen to me.” For cases that do make it to court, the legal process can be excruciatingly painful and slow for families, and convictions are rare, according to the Childline India Foundation.

The government has made moves to strengthen its laws on child sex abuse, as well as its institutions protecting the rights of children. Last year, it passed the Protection of Children from Sexual Offences Act, a landmark law that made all forms of sexual abuse against children criminal offenses for the first time in India. Child rights are also overseen by the National Commission for the Protection of Child Rights (NCPCR), a watchdog group set up by the government after the bodies of at least 19 children and young women who had gone missing over a period of months from a slum were found in an affluent neighborhood near New Delhi in 2006.

A large part of the challenge in combating child sex abuse will be making sure that India’s laws and recommendations are implemented throughout the legal system. It will also be creating an entirely new way of thinking about the problem. “There is such a culture of silence that even if a child wants to report what happens to her, she doesn’t have the words,” says Shantha Sinha, the chairperson of the NCPCR. “And it’s not just the victim that doesn’t have the vocabulary…We need to build a new script.”